Provider Demographics
NPI:1801164884
Name:LEWIS, ASHLIE AILEEN (RD)
Entity type:Individual
Prefix:MS
First Name:ASHLIE
Middle Name:AILEEN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 MERRYDALE RD APT 6
Mailing Address - Street 2:APT #6
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-3945
Mailing Address - Country:US
Mailing Address - Phone:559-280-0955
Mailing Address - Fax:
Practice Address - Street 1:280 MERRYDALE RD APT 6
Practice Address - Street 2:APT #6
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-3945
Practice Address - Country:US
Practice Address - Phone:559-280-0955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered